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Home My WebLink AboutSIGNATURE CONSTRUCTION, LLC- 186- 3/16/2011 Signature Construction, LLC Check: 186 720 3rd Ave., SW Date: 3/16/2011 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 18 40,565.63 40,565.63 0.00 0.00 40,565.63 App 18 on parking garage 40,565.63 40,565.63 0.00 0.00 40,565.63 186 3/16/2011 ""'"""40,565.63 THE SUM OF FORTY THOUSAND FIVE HUNDRED SIXTY FIVE DOLLARS AND 63 CENTS'''. Signature Construction, LLC 720 3rd Ave., SW Carmel, IN 46032 Signature Construction, LLC Check: 186 720 3rd Ave., SW Date: 3/16/2011 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 18 40,565.63 40,565.63 0.00 0.00 40,565.63 App 18 on parking garage 40,565.63 40,565.63 0.00 0.00 40,565.63 APPLICATION AND CERTIFICATION FOR PAYMENT AM DOCUMENT G702 PAGE ONE OF 2 PAGES2 TO OWNER CRC at City of Carmel PROJECT: 7C-3 VOG Parking Garage APPLICATION NO.Appticatiion S Is Distribution to: Application# 18 Signature costs OWNER Cannel Indiana 46052 ARCHITECT PERIOD TO: 12/16/2010 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Carmel, Indiana 46032 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made fur payment,as shown below,in colwection with the Contract, information and belief the Work covered by this Application for Payment has been Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due. L ORIGINAL CON TRACT SLIM $ 870.619.40 2, Net change by Change Orders $ 0.00 CONTRACTOR: 3, CONTRACT SUM TO DATE (Line 1 +2) $ 870,619.40 � � �� 4. TOTAL COMPLETED&STORED TO S 807,068-86 fly / Date: fo �7 fa 5, RETAINAGE: ihemas E tic ntz, President / j, a. 0 %of Completed Work 5 0 Sub4cribed and sy om to before me this f day of l-�- �O _ (Column D+E on 0703) b. %of Stored Material $ .+,,, wcf LINDAockCHANyN -� - Hancock County Ex Eft (Column F on G703) %I:Commission Expires Total Retainaee(Lines Sa+Sb or August 20,2011 Total in Column I of 0703) S 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT '° ` - °"°`-" 6. TOTAL EARNED LESS RETAINAGE S 807,068.86 In accordance with the Contract Documents,based on on-Se observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge, infomiation and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Cenifcate) $ 766,503.24 the quality of the Work is in accordance with the Contract Documents,and the Contractor S. CURRENT PAYMENT DUE $ 40,565.63 is entitled to payment of the AMOUNT CERTIFIED, 9_ RALANCE TO FINISH, INCLUDING RETAINAGE $ 63,550.54 90��• (3 (Line 3 less Line 6) AMOUNT CERTIFIED $ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach expkanalion ifamounr certified dffersfrom the amount applied initial aRfigures on this • Total changes approved Application and onthe Continuation Sheet that or changed to conform with the amount Cell flied. hl previous months by Owner • tea.--✓1. r _ total approved this Month Sy: . y Date: //ilk TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein_Issuance,payment and acceptance or pavnlent arc without NET CFIANGFS by Change Order $0,00 prejudice to any rights of the Owner or Contractor under this Contract, AiA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT'1352 EDITION AIA 51592 THE AMERICAN INSTITUTE OF ARCHITECTS.1735 NEWYORK AVE.,M.W. WASHINGTON,DO 200e6-5202 Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee. n 1tl V V J. CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA ) COUNTY OF HAMILTOP ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and /or labor as follows: Construction Management Services for a project known as Village on the Green Parcel 7c Parking Garage, located at Carmel, Indiana and owned by the Carmel Redevelopment Commission and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of forty thousand five hundred sixty-five dollars and sixty-three cents($40,565.63) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, finished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC (Thomas `/Koontz, President Subscribed and sworn to before me this: /-7// 7///a Notary Public° -64-s."- ;INCA BUCHANAN Hancock County r,Jy Commission Expires August 20,2011 SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Application # 18 12/1.6/10 7C-3 VOG Parking Garage Carmel , Indiana WORE COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO NO. WORE VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH RETAINAGE 101 Pre-Construction Services 66,557.63 66,557. 63 0.00 0.00 66,557.63 100% 0.00 0-00 100 General Requirements: Testing & Inspecting 66,271.98 46,185.37 6,850.00 0.00 53,035.37 80% 13,236.61 11.011 Project Management 47,629.00 28,487.50 2,634.12 0.00 31,121.62 65% 16,707.38 0.00 Site Supervision 181,987.31 169,566.43 12,420.88 0.00 181,987.31 100% 0.00 0.00 Site Safety Director 10,894.00 5,062.31 3,977.24 0.00 9,039.55 83% 1,854.45 0.00 Design Drawings 12,256.00 2,196. 92 61.20 0.00 2,258.12 18% 9,997.88 0.00 Temporary Electric 12,256.00 12,248.84 0.00 0.00 12,248.84 100% 7.16 0.00 Temp Fire Protection 1,838.00 0.00 0.00 0.00 0.00 0% 1,838.00 0.00 Temp Lighting 5,426.60 175.39 0.00 0.00 175,39 3% 5,251.21 0.00 Temp Water 1,843.82 145.39 0.00 0.00 145.39 8% 1,698.43 0.00 Sanitary Facilities 497.00 40.04 0.00 0.00 40.04 8% 456.96 0.00 Field Office 12,746.00 12,427. 64 218.22 0.00 12,645.66 99% 100.14 0.00 Temp Electric 2,451.19 2,451.19 0.00 0.00 2,451.19 100% 0.00 0.00 Office Supplies 2,451.00 2,351.41 0.00 0.00 2,351.41 96% 99.59 0.00 Temp Phone 4,657.00 504.23 256.07 0.00 760.30 16% 3,896.70 0.00 Temp Water 490.00 157.45 0.00 0.00 157.45 32% 332.55 0.00 Tools 5 Equipment 19,610,00 19,444.49 0.00 0.00 19,444.49 99% 165.51 0.00 Temp Fence 1,634,00 734.13 0.00 0.00 734.13 45% 899.87 0.00 Project Signage 1,225,00 593.00 0.00 0.00 593.00 48% 632.00 0.00 Field Eng Surveying 3,268,00 1,245.76 0.00 0.00 1,245.76 38% 2,022.24 0.00 Health & Safety 2,451.00 1,327.06 588.65 0.00 1,915.71 78% 535.29 0.00 Waste Disposal 10,725.23 7,478.75 3,098. 10 0.00 10,576.85 998 148.38 0.00 Egress Path 8,032.50 0.00 7,650.00 0.00 7,650.00 95% 382.50 0.00 Change Orders 5,074.95 0.00 2,403.97 0.00 2,403.97 0% 2,670.98 0.00 199 Construction Management Fee 388,146.19 387,122.31 407.18 0.00 387,529.48 100% 616.71 0.00 870,619.40 766,503.24 40,565.63 0.00 807,068.86 93% 63,550.54 0.00